What is the Department of Health doing about HIV?

We put 10 questions to Health Minister Michelle O'Neill. The following responses were issued by the Department of Health.

1. NI’s Sexual Health Promotion Strategy and Action Plan expired in December 2015. Is any work being done on a new strategy? If so, when will it be in place and how much money will be allocated to it?

PHA developed and ran a sexual health campaign ‘Choose to protect yourself – always use a condom’ June - December 2015. The PHA continues to promote sexual health messages and the campaign will be run again in 2016/17.

2. The last sexual health strategy included plans for a public information campaign focusing on key sexual health messages including HIV. Did this happen?

A health promotion campaign targeting MSM [men who have sex with men] was rolled out during 2013/14 and 2014/15. The campaign promoted consistent testing messages and an increased awareness of HIV, Syphilis and Gonorrhoea.

The core message of the campaign was ‘Have unprotected sex and you could be sleeping with everyone your partners ever slept with. Choose to protect yourself – always use a condom’.

Departmental guidance has been issued which includes action on improving access to HIV testing so that people would be aware of their status sooner and so enable effective management of their condition and reduce the chances of onward transmission.

3. In response to a FOI request, the Department of Health told us it does not hold any documentation on caring for elderly people with HIV/AIDS in Northern Ireland’s care homes or other health care settings stating: “There is nothing relating to this held in the department.” This response suggests that department is not preparing for people with HIV living into old age. Is any work being done?

Health and Social Care organisations are working to ensure their services are meeting the needs of all individuals living with or affected by HIV.

4. I also asked, via FOI, if all nurses and doctors working in NI have received HIV/AIDS training. Again: “The department does not hold this information.” Is the department satisfied that all staff have received HIV training?

The Department funds HIV training for nurses and midwives through the Post Registration Education Commissioning process. Staff who require HIV training are identified by all five trusts based on their annual learning needs analysis. Two programmes are available locally for staff to access. Queen’s University Belfast offers a standalone module entitled Theory for the management of sexually transmitted infections and sexual health. The HSC Clinical Education Centre also offer a HIV and STI awareness workshop.

5. Are you concerned about the number of people being diagnosed with HIV here each year? Are people becoming complacent about getting HIV? Late diagnosis is also an issue – what is the department doing about this?

Departmental guidance has been issued which includes action on improving access to HIV testing so that people would be aware of their status sooner and so enable effective management of their condition and reduce the chances of onward transmission.

The Department has asked the PHA to host a workshop with key stakeholders to review progress and consider the next actions to inform a regional sexual health action plan. Any new costs for service developments will be considered as part of the commissioning process.

6. We have spoken to a group of people living with HIV in Northern Ireland and they talked about stigma surrounding the condition. Do you agree that stigma and discrimination remain a serious issue for people with HIV in NI? What is the department doing to tackle this?

Health Minister Michelle O’Neill said: “Those living with HIV should not have to endure discrimination or stigma. Misinformation about HIV contributes to stigma and discrimination. The Public Health Agency continues to promote sexual health messages. I welcome the efforts of a number of voluntary organisations who provide a range of services, including raising awareness of HIV and providing support for those living with HIV.”

7. How many people in Northern Ireland are currently being treated with HIV/AIDS drugs therapies?

934 HIV-diagnosed persons were seen for HIV care in 2015. Data for the north of Ireland for 2015 can be found in the HIV Surveillance Data Tables produced annually by Public Health England. The PHA will publish its report of the analysis of the data for World AIDS Day.

8. Is the department doing any work to determine or monitor the long term impact of strong daily medication taken by people living with HIV?

The Belfast Trust is responsible for the Regional Centre for HIV at the Royal Victoria Hospital. They have data on key performance indicators that determine early diagnoses of HIV and better long term outcome.

9. The PHA has confirmed that HIV was detected during 114 antenatal screening tests of pregnant women in the 10 years 2006-15. What do you think of these figures?

In the north of Ireland, all pregnant women are offered a screening blood test to check for HIV. The blood test is part of the booking bloods offered at a woman’s first antenatal appointment. The vast majority of women screened will not be infected but for those who are, the benefits of screening are substantial. All HIV-positive women require treatment and interventions during pregnancy and delivery with the aim of reducing to a minimum the risk of transmission of HIV to the baby.

Antenatal screening for HIV is one of the most successful HIV prevention interventions. The aim of this programme is to prevent mother-to-child transmission of HIV through management of the mother and the newborn with antiretrovirals and avoidance of breastfeeding. To date there has been no case of HIV transmission to the newborn since the screening programme started where antenatal and perinatal care have been provided in the north of Ireland for women whose HIV positive status is known. This includes both mothers newly diagnosed through antenatal HIV screening and women with known HIV who have become pregnant.

It is important to protect oneself and to reduce the spread of the infection. People who are sexually active other than in a monogamous relationship should use condoms and should limit the number of sexual partners they have.

Anyone who thinks they may be at risk should get tested. Knowing one’s HIV status is critical for effective treatment and for the prevention of transmission.

Early diagnosis is important. People respond better to treatment if they are diagnosed at an earlier stage of disease.

10. Can you tell me how many self-testing HIV kits have been sold into Northern Ireland since the ban was lifted?

Self-testing provides another option to reach out to those who are unwilling or unable to take an HIV test in a clinic. The Department does not routinely measure the sale and uptake of HIV self-testing kits. Anyone can request a free HIV test from their GP or at a GUM clinic.